Mahmood Bushra, Li Gordon, Li Julia, Wilton James, Tang Tricia S, Velásquez García Héctor Alexander, Wong Stanley, Jain Akshay B, Naveed Zaeema, Garg Arun, Nandra Amandeep, Janjua Naveed Zafar, McKee Geoffrey
Division of Endocrinology, Department of Medicine, University of British Columbia, Vancouver, BC V5Z 1M9, Canada.
British Columbia Center for Disease Control (BCCDC), Vancouver, BC V5Z 4R4, Canada.
Int J Environ Res Public Health. 2025 Mar 28;22(4):519. doi: 10.3390/ijerph22040519.
In British Columbia (BC), Canada, COVID-19 and associated control measures impacted routine care for patients with diabetes. Some of these measures may have impacted timely screening and diagnosis of type 2 diabetes. We assessed the impact of control measures on screening and diagnosis of type 2 diabetes in BC.
We used data from the BC COVID-19 Cohort, which includes COVID-19 and healthcare administrative data on all residents of BC. We assessed and compared screening (≥40 yrs) and diagnosis (≥18 yrs) of diabetes among the adult population during the pandemic period (1 April 2020-31 December 2022), with 1 January 2016-31 March 2020 used as a historical reference period. We used interrupted time series with generalized additive models to evaluate the impact of policy measures on screening and diagnoses trends.
We observed an initial decline in the mean number of screenings and diagnoses. In the third post-policy phase (January 2022-December 2022), there was a 4.8% (-5.1, 15.4) increase in screenings while after an initial reduction in diabetes diagnoses, we observed a significant increase of 31.6% (17.8, 46.6) in the third post-policy phase. Further stratification by age and sex showed the entire increase in diagnoses trends was driven by younger females with a 56.4% (25.1, 92.9) and 58.7% (38.2, 81.3) increment in diagnoses in the 18-29 and 40-49 age groups, respectively.
The initial reduced number of screenings and diagnoses followed by the significant upward trend in diabetes diagnoses in the later post-policy phase have important clinical and public health implications. Further research is needed to understand the post-pandemic increase in diabetes among females.
在加拿大不列颠哥伦比亚省（BC），2019冠状病毒病（COVID-19）及相关防控措施影响了糖尿病患者的常规护理。其中一些措施可能影响了2型糖尿病的及时筛查和诊断。我们评估了防控措施对BC省2型糖尿病筛查和诊断的影响。
我们使用了BC省COVID-19队列的数据，其中包括BC省所有居民的COVID-19和医疗管理数据。我们评估并比较了疫情期间（2020年4月1日至2022年12月31日）成年人群中糖尿病的筛查（≥40岁）和诊断（≥18岁）情况，并将2016年1月1日至2020年3月31日作为历史参考期。我们使用带有广义相加模型的中断时间序列来评估政策措施对筛查和诊断趋势的影响。
我们观察到筛查和诊断的平均数量最初有所下降。在政策实施后的第三个阶段（2022年1月至2022年12月），筛查数量增加了4.8%（-5.1，15.4），而在糖尿病诊断最初减少之后，我们观察到在政策实施后的第三个阶段显著增加了31.6%（17.8，46.6）。按年龄和性别进一步分层显示，诊断趋势的整体增加是由年轻女性推动的，在18 - 29岁和40 - 49岁年龄组中，诊断增加分别为56.4%（25.1，92.9）和58.7%（38.2，81.3）。
政策实施后期糖尿病诊断数量先减少后显著上升，这具有重要的临床和公共卫生意义。需要进一步研究以了解疫情后女性糖尿病增加的情况。
